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Before the crisis

The three countries at the centre of the current Ebola outbreak, Sierra Leone, Liberia and Guinea, were ranked towards the bottom of the 2013 Human Development Index. Out of 187 countries and territories, they ranked 174 (Liberia), 177 (Sierra Leone) and 178 (Guinea).

In 2013, life expectancy in Sierra Leone was the one of lowest in the world at 48 years. Life expectancy in Liberia and Guinea was higher at 57 and 54.5 years, respectively.

The three countries were rebuilding after years of recent conflict. Sierra Leone’s civil war ended in 2002 (1991–2002), since when the country’s development index has been increasing rapidly.

Liberia has been through two civil wars since 1989, the second ending in 2003.

Sharing borders with both Liberia and Sierra Leone, Guinea was occasionally drawn into the conflicts in those countries in 2000. Rioting and political protests have taken place as recently as 2013.

Healthcare resources in the most affected countries were already stretched, with Guinea having 10 physicians per 100,000 people and Liberia just 1.4.

Ebola was first identified in 1976 in two simultaneous outbreaks, one in Sudan and the other in the Democratic Republic of Congo, according to the WHO.

Since the first outbreak there have been 33 incidents of Ebola, including the 2014 crisis.

THE IMPACT OF THE CRISIS

In March 2014, a rapidly evolving outbreak of Ebola virus disease started in Guinea and spread to Liberia, Sierra Leone, Nigeria and Senegal.

Intense transmission of Ebola took place in Sierra Leone, Liberia and Guinea and these were therefore the three countries worst affected by the crisis.

When the DEC launched its appeal on 29 October 2014, more than 13,000 cases of confirmed or suspected Ebola had been reported in Guinea, Sierra Leone and Liberia, and almost 5,000 had died.

This outbreak was unprecedented in terms of its scale, severity and complexity. There were more cases and deaths in this outbreak than all others combined, according to WHO.

Cases of Ebola also occurred in Nigeria, Senegal, Mali, Spain, the USA and the UK in 2014, and in Italy in 2015. An unrelated outbreak also occurred in the Democratic Republic of Congo.

Healthcare workers were particularly vulnerable to the disease due to their high risk of exposure. According to WHO, there were 815 confirmed and probable cases of Ebola among medical staff in the worst-affected countries, of whom two-thirds died.

The final number of cases and deaths according to WHO stood at 28,616 and 11,310 respectively.

DEC APPEAL AND RESPONSE

The DEC Ebola Crisis Appeal was launched on 29 October 2014, with appeals carried by all major UK broadcasters. It raised more than £37 million and helped hundreds of thousands of people.

Twelve of the DEC’s members – some of the UK’s leading aid charities – responded across Guinea, Sierra Leone and Liberia, reaching 2.85 million people In Phase 1 of the response (October 2014 to April 2015), including an estimated 1 million people with relief assistance.

Phase 1 focused on preventing the spread of the disease. DEC members helped to mobilise a mass community effort to halt the virus, reaching 1.85 million with health information and other activities.

More than 440,000 people were trained to pass on key health messages and challenge misinformation on the spread of Ebola. This included community health volunteers who travelled door to door explaining the importance of handwashing, and distributing buckets, soap and chlorine.

Other crucial aspects of the Phase 1 response included ensuring safe and dignified burials, often challenging due to the cultural practice of washing and touching bodies before burial; and active case-finding and referral of those suspected of being infected.

In Phase 2 (May 2015 to October 2016), DEC member charities reached 1.63 million people.

With markets closed to limit the spread of Ebola, many small businesses collapsed, and quarantined farmers were unable to plough and plant their fields. DEC members helped people to find new ways to earn a living or to rebuild their devastated businesses. Almost 47,000 people were given cash grants so they could buy seeds to plant or goods to sell in reopened markets; and more than 17,000 women in Liberia were trained to run small businesses, such as making and selling soap, and tailoring.

Rainwater harvesting was piloted in a region of Sierra Leone that had previously relied on wells. In addition to drying up during the dry season, wells cannot be built after the onset of the rainy season. Rainwater harvesting systems, including water tanks capable of collecting and storing up to 6,000 litres of rainwater, were installed in 24 schools, giving students and teachers quicker access to a vital water supply.

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The Disasters Emergency Committee brings together 14 leading UK aid agencies to raise money at times of humanitarian crisis in poorer countries. By working together we can raise more money to save lives and rebuild shattered communities.